Semantic Feature Analysis (SFA) for Word Finding Difficulties: A Guide for SLPs

At a glance

What is Semantic Feature Analysis? Talk through key features (group, use, action, properties, location, association) to support a speaker’s word-finding ability.

Who is it best suited to? Best for mild or moderate expressive aphasia with reasonable comprehension. Can be adapted, with additional support, for more significant aphasia.

Why use Semantic Feature Analysis? Shown to improves naming for trained items and builds circumlocution strategy for real-life repair.

Semantic Feature Analysis (SFA) is a widely used evidence-based therapy for expressive aphasia that supports naming by activating a person’s semantic knowledge and the connections between related concepts. The therapist helps the client explore different features of the target word, for example, what it is used for, what it looks like, what category it belongs to, and where you would find it.
SFA can be used with clients who show signs of impairment in their semantic system. Indicators of this could be that they make semantic errors (e.g., “apple” in place of “pear”) and respond to semantic cues in naming activities.
It is also used with other populations beyond individuals with expressive aphasia. SFA-style semantic mapping is widely used in schools to build vocabulary and reading comprehension. SFA can also be used to support naming maintenance in primary progressive aphasia.

Why use it?

SFA is a straightforward, practical, and evidence-based approach (see “Evidence” below). While SFA is primarily an impairment-based therapy, it can also result in the person with aphasia becoming more skilled at circumlocution (i.e., “talking around” the word) as a repair or self-cueing strategy.

Who is SFA best suited to?

Clients with mild or moderate expressive aphasia who:
• Have reasonable comprehension
• Respond to semantic cues
• Can convey at least some key information about a target with support (speaking, writing, drawing, gesture)

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Evidence

In a single-subject study, Boyle & Coelho (1995) found that training nouns with SFA resulted in reliable gains, but generalization to untrained items was mixed.

A review by Boyle (2010) reported improved naming across several aphasia types (e.g., anomic, conduction, Broca’s, Wernicke’s, transcortical motor, and TBI-related aphasia), with most participants in the mild–moderate range and variability in the extent of generalization and maintenance.

Maddy et al. (2014) meta-analysis found medium–large treatment effects for confrontation naming of trained items in aphasia, but again limited or inconsistent generalization to untrained words and connected speech. A systematic review by Efstratiadou et al. (2018) reached similar conclusions, showing favorable outcomes for trained items with methodological heterogeneity across studies.
Wambaugh et al. (2014) found that SFA can also support verb retrieval and that pairing SFA with sentence-level therapy (e.g., Verb Network Strengthening Treatment) may better target connected-speech goals.

Kiran & Thompson employed an SFA-style protocol and found that training atypical (complex) items can sometimes promote within-category generalization to more typical items. For example, targeting less common words (e.g., “penguin”) resulted in generalization to more common words (e.g., “robin”). However, training on more common words did not result in the same benefits for less common words.
Freed & Torstensen (2013) found SFA and PACE both improved trained words in chronic Broca’s aphasia, with some generalization.

What you’ll need for an SFA session

• A pack of pictures or real objects. Start with familiar, everyday items. You will primarily be focusing on those that the client struggles to name from the set—so, depending on their word-finding ability, you may need more pictures.
• A pen and printed SFA charts.

Download our Free SFA Starter Pack here for everything you will need
• 2× pre-made sets of SFA charts to print
• SFA chart template to create your own
• SFA Quick Guide for family and carers

Example SFA Session Plan

1. Warm-up & set-up
• Introduce SFA:

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“We are going to work on describing the harder words. We’ll talk about things like what group they belong to, what they are used for, and what they are made of. This often helps the word come.”

• Select a picture set. Focus on functional targets as generalization to untrained items is likely to be limited.

2. Clinician models one full example:
Shows chart with picture of the target word at its center - in the example below “coffee”. The clinician answers each question in turn and writes this down on the chart.
• Group: “What group does it belong to? … It’s a drink.”
• Use: “What do you use it for? … You drink it for energy.”
• Action: “You pour and sip it.”
• Properties: “Hot, black or brown, smells nice.”
• Location: “Found in a kitchen or a café.”
• Association: “Makes me think of mugs, beans, catching up with friends”.
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3. Carry out SFA with 5-10 targets that the client struggles to name.
Ask the client to name the target pictures. For those that they struggle to name, complete the process below.
Elicit semantic features box-by-box. Write down the features on the chart as you go. Allow the client plenty of time. Do not name the target for them yet if they are struggling - guide them through the SFA questions first. Doing so may ultimately help them to name it later in the activity.

The six SFA prompts

For nouns
• Group: “What kind of thing is it?”
• Use: “What do you use it for?”
• Action: “What does it do, or what do you do with it?”
• Properties: “What does it look or feel like?”
• Location: “Where do you find or keep it?”
• Association: “What does it go with or remind you of?”

For verbs
• Who: “Who usually does this?”
• Why: “Why do you do this?”
• How: “What body part or tool do you use?”
• Where: “Where does this happen?”
• When: “When does it happen? How often?”
• Result: “What happens after? What changes?”

Keep prompts short. Give the client time. Praise clues in whatever form the client can express them.
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4. If the client struggles to answer the semantic questions, you can step down as follows:

More help:
1. Two-choice questions (e.g. “Is it found in the kitchen or the garden?”)
2. Yes/no checks (“Is it found in the garden?”)
3. Pointing/gesture/drawing (“Can you show me or draw where it is found?”)
4. Phrase completion cue (e.g. “It is found in the…”)
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5. Once all or most of the features have been identified, ask the client to try naming the target again.
If the client is still struggling to name the target, the clinician can try:
1. Providing a phrase completion cue, e.g. “I drank a strong cup of black …”
2. Providing a phonemic cue
3. Providing a written cue
4. Provide the target word for the client to repeat
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6. Once the client retrieves or repeats the word, reinforce and link back:
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“Yes, coffee! That’s the hot, black drink - we often find in the kitchen”.

How to make SFA personalized and meaningful

To make SFA as functional and useful as possible, focus on targets that the client will need to use often and that are important to them. Given that improvements will likely be limited mostly or entirely to targets trained in sessions, it is crucial to target the right categories and vocabulary.
You can adapt SFA to target names of family and friends (e.g., Who are they married to? Who are their children? Where do they live? What do they look like? What do they do for work? What are their hobbies?). You can also target favorite places, belongings, or hobbies.

Home practice

Provide the client and/or their family with SFA charts and our quick guide to support their practice.
Download our Free SFA Starter Pack here for everything you will need:
• Pre-made sets of SFA charts to print
• A blank chart template to create your own SFA chart resources
• SFA Quick Guide for family and carers

FAQ

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What is Semantic Feature Analysis (SFA)?
A naming therapy that strengthens links between words and meanings by talking through features (group, use, action, properties, location, association).
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Who is SFA suitable for?
People with mild–moderate aphasia who can express some information about a target word. The client will need reasonable comprehension to engage in the activity. SFA can be adapted for more severe presentations. It is best suited where the client shows signs of semantic impairment (e.g., makes semantic errors or benefits from semantic cues).

Does it help everyone?
Not always. For appropriate candidates, improvement is likely in naming trained targets; generalization to untrained targets may be very limited.
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How often? How long should sessions be?
Most published SFA studies (e.g., Boyle & Coelho, 1995; Boyle, 2004; Kiran & Thompson, 2003; Maddy et al., 2014) used SFA protocols with 45–60 minute sessions, delivered 2–3 times a week, over 10–20 sessions total.
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Can you also use SFA to work on naming verbs?
Yes. The prompts can be adapted to target verbs. For example, “Who does this?”, “Why would you do this?”, “Where does it happen?”, “What body part or tool do you use?”.
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What if the word never comes?
SFA can still be valuable even if the client cannot name the target word after identifying the semantic features. Continued work on a target may result in improvements. Furthermore, practicing SFA teaches circumlocution (talking around the word), which is a useful repair strategy even if the word is not triggered.
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How can family and carers help with SFA?
Family and carers can support delivery of SFA practice between clinician sessions. Use an SFA prompt card, give time, and praise clues.
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Should the client be asked to generate semantic features for all targets, or only those they struggle to name?
Focus on carrying out the SFA process for those words that the client struggles to name.

About the author

Oli Cheadle is a UK-based speech and language therapist at Cognishine and a practicing clinician in stroke rehabilitation, working across aphasia, apraxia of speech, dysarthria, dysphagia. He also specializes in the therapy for stuttering.
He runs The Aphasia Therapy Planner - a website that helps speech and language therapist find appropriate aphasia therapies for clients www.aphasiatherapyplanner.weebly.com/
Oli also runs Stuttering Therapy Online (https://www.stutteringtherapyonline.com/), a private therapy practice and hub of information and guides about stuttering.

References

Boyle, M., & Coelho, C. A. (1995). Application of Semantic Feature Analysis as a Treatment for Aphasic Dysnomia. American Journal of Speech-Language Pathology, 4(4), 94–98. https://doi.org/10.1044/1058-0360.0404.94
Boyle, M. (2010). Semantic feature analysis treatment for aphasic word retrieval impairments: What’s in a name? Topics in Stroke Rehabilitation, 17(6), 411–422. https://doi.org/10.1310/tsr1706-411
Maddy, K. M., Capilouto, G. J., & McComas, K. L. (2014). The effectiveness of semantic feature analysis: An evidence-based systematic review. Annals of Physical and Rehabilitation Medicine, 57(4), 254–267. https://doi.org/10.1016/j.rehab.2014.03.002
Efstratiadou, E. A., Papathanasiou, I., Holland, R., Masterson, J., & Hilari, K. (2018). A Systematic Review of Semantic Feature Analysis Therapy Studies for Aphasia. Journal of Speech, Language, and Hearing Research, 61(5), 1261–1278. https://doi.org/10.1044/2018_JSLHR-L-16-0330 (open-access author manuscript: City, University of London).
Wambaugh, J. L., Wright, S., & Mauszycki, S. (2014). Semantic feature analysis: Application to confrontation naming of actions in aphasia. Aphasiology, 28(1), 1–24. https://doi.org/10.1080/02687038.2013.845739
Kiran, S., & Thompson, C. K. (2003). The role of semantic complexity in treatment of naming deficits: Training atypical exemplars leads to generalization to typical exemplars. Aphasiology, 17(5), 389–406. (Open-access version available via PMC.)
See also: Kiran, S. (2007). Complexity in language learning and treatment. American Journal of Speech-Language Pathology, 16(1), 43–56. https://doi.org/10.1044/1058-0360(2007/002)
Freed, D., & Torstensen, K. (2013). A comparison of Semantic Feature Analysis and Promoting Aphasics’ Communicative Effectiveness for treating anomia in patients with aphasia. Paper presented at the Clinical Aphasiology Conference (Tucson, AZ). (Conference abstract/slides referenced online; appears not to be a peer-reviewed journal article.)

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